Strawberry gingivitis as an initial presentation of granulomatosis with polyangiitis in an older adult

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Gerodontology Pub Date : 2025-02-28 DOI:10.1111/ger.12797

José Alcides Almeida de Arruda, Victor Zanetti Drumond, Maria Danielle Fontes, José Victor Lemos Ventura, Jefferson R. Tenório, Bruno Augusto Benevenuto de Andrade

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引用次数: 0

Abstract

Objective

To describe a rare case of granulomatosis with polyangiitis (GPA) in an older adult in light of the existing literature.

Background

GPA is a potentially life-threatening multisystem necrotising vasculitis, characterised by a spectrum of oral mucosal lesions that present diagnostic challenges.

Materials and Methods

A 76-year-old female patient presented with asymptomatic granular and haemorrhage swelling (“strawberry” gingivitis) affecting the upper and lower anterior and posterior gingivae. Cytoplasmic antineutrophil cytoplasmic antibody (ANCA) was positive. Concurrent kidney lesions were diagnosed.

Results

Histopathological examination revealed a pseudoepitheliomatous proliferation with perivascular inflammation and a dense eosinophilic infiltrate. After a 5-year follow-up, the patient showed no signs of recurrence. A literature review performed using PubMed, Web of Science and Scopus identified 22 documented cases of GPA-related oral lesions in older adults, with equal sex distribution and 63.6% occurring in the seventh decade of life.

Conclusion

Early recognition and diagnosis of “strawberry” gingivitis in older adults with GPA are crucial, as these oral manifestations may be the initial presentation of the disease.

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草莓牙龈炎作为肉芽肿病的最初表现与多血管炎在一个老年人

目的结合文献报道一例罕见的老年人肉芽肿病合并多血管炎（GPA）。背景GPA是一种潜在危及生命的多系统坏死性血管炎，其特征是一系列口腔黏膜病变，存在诊断挑战。材料与方法女性，76岁，以无症状颗粒状出血性肿胀（“草莓”型牙龈炎）累及上下前后龈。胞浆抗中性粒细胞胞浆抗体（ANCA）阳性。同时诊断肾脏病变。结果组织病理学检查显示假上皮瘤增生伴血管周围炎症和致密嗜酸性粒细胞浸润。经过5年的随访，患者无复发迹象。使用PubMed、Web of Science和Scopus进行的文献综述确定了22例老年人gpa相关口腔病变的记录病例，性别分布均匀，63.6%发生在生命的第七个十年。结论早期识别和诊断老年GPA患者的“草莓”牙龈炎至关重要，因为这些口腔表现可能是该疾病的最初表现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gerodontology 医学-老年医学

CiteScore

4.10

自引率

10.00%

发文量

审稿时长

3-6 weeks

期刊介绍： The ultimate aim of Gerodontology is to improve the quality of life and oral health of older people. The boundaries of most conventional dental specialties must be repeatedly crossed to provide optimal dental care for older people. In addition, management of other health problems impacts on dental care and clinicians need knowledge in these numerous overlapping areas. Bringing together these diverse topics within one journal serves clinicians who are seeking to read and to publish papers across a broad spectrum of specialties. This journal provides the juxtaposition of papers from traditional specialties but which share this patient-centred interest, providing a synergy that serves progress in the subject of gerodontology.